@layout("/common/_form.html",{js:["/assets/manager/flowProblem/flowProblem_edit.js"]}){

<form class="layui-form" id="flowProblemForm" lay-filter="flowProblemForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="problemId" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">反馈类型<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <select name="problemType" id="problemType" lay-filter="problemType">
                                <option value="">下拉单选框</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">问题内容<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <textarea name="problemDetail" id="problemDetail" placeholder="请输入问题内容" class="layui-textarea" lay-verify="required" required></textarea>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">状态</label>
                        <div class="layui-input-block">
                            <select name="status" id="status" lay-filter="status">
                                <option value="0">待处理</option>
                                <option value="1">处理中</option>
                                <option value="2">已处理</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">处理内容</label>
                        <div class="layui-input-block">
                            <textarea name="note" id="note" placeholder="请输入内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">处理人</label>
                        <div class="layui-input-block">
                            <input id="manageUser" name="manageUser" placeholder="请输入处理人" type="text" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">联系电话</label>
                        <div class="layui-input-block">
                            <input id="memberPhone" name="memberPhone" placeholder="请输入联系电话" type="text" class="layui-input"/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}